Provider Demographics
NPI:1942625116
Name:KREPS, PAMELA W (BC-HIS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:W
Last Name:KREPS
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 HORIZON DR STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8737
Mailing Address - Country:US
Mailing Address - Phone:970-628-4927
Mailing Address - Fax:970-628-4925
Practice Address - Street 1:759 HORIZON DR STE E
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-628-4927
Practice Address - Fax:970-628-4925
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000254237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist